Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone

Abstract

Apparatus for attaching an object to bone, the apparatus comprising: a suture assembly comprising: a first suture having a generally U-shaped configuration comprising a first arm, a second arm and a bridge connecting the first arm to the second arm; a second suture comprising a first arm, a second arm and a bridge connecting the first arm to the second arm; the first arm of the second suture being wrapped around the first arm of the first suture in a first direction, and the second arm of the second suture being wrapped around the second arm of the first suture in a second, opposite direction; the suture assembly being capable of assuming (i) a longitudinally-extended, radially-contracted first configuration, and (ii) a longitudinally-contracted, radially-expanded second configuration; wherein at least one of the first arm and the second arm comprises a hollow tubular structure.

What is claimed is: 
     
       1. Apparatus for attaching an object to bone, the apparatus comprising:
 a suture assembly comprising:
 a first suture having a generally U-shaped configuration comprising a first arm, a second arm and a first bridge connecting the first arm of the first suture to the second arm of the first suture; 
 a second suture comprising a first arm, a second arm and a second bridge connecting the first arm of the second suture to the second arm of the second suture; 
 the first arm of the second suture being wound helically around the first arm of the first suture in a single first direction, and the second arm of the second suture being wound helically around the second arm of the first suture in a single second, opposite direction; 
 wherein the first arm of the second suture is wound three times around the first arm of the first suture and the second arm of the second suture is wound three times around the second arm of the first suture; 
 the suture assembly being capable of assuming (i) a longitudinally-extended, radially-contracted first configuration, and (ii) a longitudinally-contracted, radially-expanded second configuration; 
 wherein at least one of the first suture and the second suture comprises a hollow tubular structure. 
 
 
     
     
       2. Apparatus according to  claim 1  wherein the suture assembly is transformed from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration by moving the wound portions of the second suture along the first and second arms of the first suture. 
     
     
       3. Apparatus according to  claim 1  wherein the wound portions of the second suture are in a longitudinally compressed state when the suture assembly is in its second configuration. 
     
     
       4. Apparatus according to  claim 1  wherein the suture assembly is transformed from its first configuration to its second configuration by pulling the first and second arms of the first suture while holding the second bridge of the second suture steady. 
     
     
       5. Apparatus according to  claim 1  wherein the first arm of the second suture terminates in a first end, the second arm of the second suture terminates in a second end, and further wherein the first and second ends are free relative to one another. 
     
     
       6. Apparatus according to  claim 1  wherein the first suture and the second suture both comprise a hollow tubular structure. 
     
     
       7. Apparatus according to  claim 1  wherein the first suture comprises woven suture and the second suture comprises a hollow tubular structure. 
     
     
       8. Apparatus according to  claim 1  wherein the first suture comprises a hollow tubular structure and the second suture comprises woven suture. 
     
     
       9. Apparatus according to  claim 1  wherein the second suture comprises a hollow tubular structure, wherein the first arm of first suture extends along a portion of the interior lumen of the first arm of the second suture before exiting the lumen through the side wall of the first arm intermediate its length, and further wherein the second arm of first suture extends along a portion of the interior lumen of the second arm of the second suture before exiting the lumen through the side wall of the second arm intermediate its length. 
     
     
       10. Apparatus according to  claim 1  further comprising an inserter assembly for deploying the suture assembly in the anatomical structure, the inserter assembly comprising:
 an insertion tube for carrying at least a portion of the suture assembly within the insertion tube when the suture assembly is in its longitudinally-extended, radially-contracted first configuration; and 
 a push rod for engaging the suture assembly when the suture assembly is disposed within the insertion tube. 
 
     
     
       11. A method for attaching an object to an anatomical structure, the method comprising:
 providing apparatus comprising:
 a suture assembly comprising:
 a first suture having a generally U-shaped configuration comprising a first arm, a second arm and a first bridge connecting the first arm of the first suture to the second arm of the first suture; 
 a second suture comprising a first arm, a second arm and a second bridge connecting the first arm of the second suture to the second arm of the second suture; 
 the first arm of the second suture being wound helically around the first arm of the first suture in a single first direction, and the second arm of the second suture being wound helically around the second arm of the first suture in a single second, opposite direction; 
 wherein the first arm of the second suture is wound three times around the first arm of the first suture and the second arm of the second suture is wound three times around the second arm of the first suture; 
 the suture assembly being capable of assuming (i) a longitudinally-extended, radially-contracted first configuration, and (ii) a longitudinally-contracted, radially-expanded second configuration; 
 wherein at least one of the first suture and the second suture comprises a hollow tubular structure; 
 
 
 inserting the suture assembly into an opening in the anatomical structure while the suture assembly is in its longitudinally-extended, radially-contracted first configuration, with the first and second arms of the first suture extending from the opening in the anatomical structure; and 
 transforming the suture assembly from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration in order to secure the suture assembly to the anatomical structure. 
 
     
     
       12. A method according to  claim 11  wherein a portion of the suture assembly has a diameter which is larger than the diameter of the opening in the anatomical structure when the suture assembly is in its longitudinally-contracted, radially-expanded second configuration. 
     
     
       13. A method according to  claim 11  wherein the suture assembly is transformed from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration by moving the wound portions of the second suture along the first and second arms of the first suture. 
     
     
       14. A method according to  claim 11  wherein the wound portions of the second suture are in a longitudinally compressed state when the suture assembly is in its second configuration. 
     
     
       15. A method according to  claim 11  wherein the suture assembly is transformed from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration by pulling the first and second arms of the first suture while holding the second bridge of the second suture steady. 
     
     
       16. A method according to  claim 11  wherein the suture assembly is inserted into the opening in the anatomical structure while the suture assembly is disposed within a tube. 
     
     
       17. A method according to  claim 16  wherein the suture assembly is transformed from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration after the tube has been withdrawn from the opening formed in the anatomical structure. 
     
     
       18. A method according to  claim 16  wherein the suture assembly is transformed from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration after the suture assembly has been ejected from the tube. 
     
     
       19. A method according to  claim 18  wherein the suture assembly is transformed from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration while the tube is still in the opening formed in the anatomical structure. 
     
     
       20. A method according to  claim 16  wherein the suture assembly is compressed within the tube. 
     
     
       21. A method according to  claim 11  wherein the first suture and the second suture both comprise a hollow tubular structure. 
     
     
       22. A method according to  claim 11  wherein the first suture comprises woven suture and the second suture comprises a hollow tubular structure. 
     
     
       23. A method according to  claim 11  wherein the first suture comprises a hollow tubular structure and the second suture comprises woven suture. 
     
     
       24. A method according to  claim 11  wherein the second suture comprises a hollow tubular structure, wherein the first arm of first suture extends along a portion of the interior lumen of the first arm of the second suture before exiting the lumen through the side wall of the first arm intermediate its length, and further wherein the second arm of first suture extends along a portion of the interior lumen of the second arm of the second suture before exiting the lumen through the side wall of the second arm intermediate its length. 
     
     
       25. A method according to  claim 11  comprising the additional step of moving a portion of the suture assembly proximally after the suture assembly is in its longitudinally-contracted, radially-expanded second configuration. 
     
     
       26. A method according to  claim 25  wherein the anatomical structure comprises bone. 
     
     
       27. A method according to  claim 26  wherein the portion of the suture assembly is moved proximally until it engages the underside of a cortical layer of the bone. 
     
     
       28. A method according to  claim 11  comprising the additional step of using at least one of the first and second arms of the first suture to secure an object to the anatomical structure. 
     
     
       29. A method according to  claim 28  wherein the object comprises soft tissue. 
     
     
       30. Apparatus for attaching an object to bone, the apparatus comprising:
 a suture assembly comprising:
 a first suture having a generally U-shaped configuration comprising a first arm, a second arm and a first bridge connecting the first arm of the first suture and the second arm of the first suture; 
 a second suture comprising a first arm, a second arm and a second bridge the first arm of the second suture and the second arm of the second suture; 
 the first arm of the second suture being wrapped around the first arm of the first suture in a first direction, and the second arm of the second suture being wrapped around the second arm of the first suture in a second, opposite direction; 
 wherein the first arm of the second suture is wound three times around the first arm of the first suture and the second arm of the second suture is wound three times around the second arm of the first suture; 
 the suture assembly being capable of assuming (i) a longitudinally-extended, radially-contracted first configuration, and (ii) a longitudinally-contracted, radially-expanded second configuration; 
 wherein the first arm of the first suture passes through the first arm of the second suture, and further wherein the second arm of the first suture passes through the second arm of the second suture. 
 
 
     
     
       31. Apparatus according to  claim 30  wherein the first arm of the first suture passes through the first arm of the second suture distal to the bridge of the second suture, and further wherein the second arm of the first suture passes through the second arm of the second suture distal to the bridge of the second suture. 
     
     
       32. Apparatus according to  claim 30  wherein at least one of the first arm and the second arm comprises a hollow tubular structure. 
     
     
       33. A method for attaching an object to an anatomical structure, the method comprising:
 providing apparatus comprising:
 a suture assembly comprising:
 a first suture having a generally U-shaped configuration comprising a first arm, a second arm and a first bridge connecting the first arm of the first suture and the second arm of the first suture; 
 a second suture comprising a first arm, a second arm and a second bridge connecting the first arm of the second suture and the second arm of the second suture; 
 the first arm of the second suture being wrapped around the first arm of the first suture in a first direction, and the second arm of the second suture being wrapped around the second arm of the first suture in a second, opposite direction; 
 wherein the first arm of the second suture is wound three times around the first arm of the first suture and the second arm of the second suture is wound three times around the second arm of the first suture; 
 the suture assembly being capable of assuming (i) a longitudinally-extended, radially-contracted first configuration, and (ii) a longitudinally-contracted, radially-expanded second configuration; 
 wherein the first arm of the first suture passes through the first arm of the second suture, and further wherein the second arm of the first suture passes through the second arm of the second suture; 
 
 
 inserting the suture assembly into an opening in the anatomical structure while the suture assembly is in its longitudinally-extended, radially-contracted first configuration, with the first and second arms of the first suture extending from the opening in the anatomical structure; and 
 transforming the suture assembly from its longitudinally-extended, radially-contracted first configuration to its longitudinally-contracted, radially-expanded second configuration in order to secure the suture assembly to the anatomical structure. 
 
     
     
       34. A method according to  claim 33  wherein the first arm of the first suture passes through the first arm of the second suture distal to the bridge of the second suture, and further wherein the second arm of the first suture passes through the second arm of the second suture distal to the bridge of the second suture. 
     
     
       35. A method according to  claim 33  wherein at least one of the first arm and the second arm comprises a hollow tubular structure.